瑞马唑仑复合舒芬太尼全身麻醉对输尿管镜 碎石术后苏醒期躁动的影响研究

A Study on the Effects of Remimazolam Combined with Sufentanil General Anesthesia on Restlessness during the Recovery Period after Ureteroscopic Lithotripsy

摘要: 目的：探究分析输尿管镜碎石术全身麻醉中复合使用瑞马唑仑与舒芬太尼对于苏醒期躁动问题的影响效果。方法：将2023年8月~2024年8月期间收治的126例输尿管结石患者案例以随机数字表法分组，对照组在丙泊酚 + 舒芬太尼复合全身麻醉下开展输尿管镜碎石术治疗，观察组在瑞马唑仑 + 舒芬太尼复合全身麻醉下开展输尿管镜碎石术治疗，对比两组躁动严重程度与麻醉恢复时间、血流动力学指标、不良反应发生概率。结果：对照组躁动发生率30.16%，观察组躁动发生率9.52% (P < 0.05)，且观察组躁动程度、苏醒时间、拔管时间、PACU停留时间低于对照组(P < 0.05)；观察组拔管时、出PACU时平均动脉压与心率均高于对照组(P < 0.05)；观察组麻醉不良反应发生率低于对照组(P < 0.05)。结论：在输尿管镜碎石术全身麻醉患者麻醉方案中，复合应用瑞马唑仑与舒芬太尼具有相对较低的苏醒期躁动风险，同时因药代动力学优势影响，能够辅助提升术后苏醒效率、降低不良反应风险，并且具有稳定血流动力学指标的积极效果。

Abstract: Objective: To explore and analyze the effect of the combined use of remimazolam and sufentanil in general anesthesia during ureteroscopic lithotripsy on the problem of restlessness during the recovery period. Methods: A total of 126 patients with ureteral calculi admitted from August 2023 to August 2024 were randomly grouped by random number table method. The control group was treated with ureteroscopic lithotripsy under combined general anesthesia with propofol and sufentanil, while the observation group was treated with ureteroscopic lithotripsy under combined general anesthesia with remimazolam and sufentanil. The severity of restlessness, time to recovery from anesthesia, hemodynamic parameters, and incidence of adverse reactions were compared between the two groups. Result: The incidence of restlessness in the control group was 30.16%, and that in the observation group was 9.52% (P < 0.05). Moreover, the degree of restlessness, recovery time, extubation time and PACU stay time in the observation group were lower than those in the control group (P < 0.05). The mean arterial pressure and heart rate of the observation group at the time of extubation and exit from the PACU were both higher than those of the control group (P < 0.05). The incidence of adverse anesthesia reactions in the observation group was lower than that in the control group (P < 0.05). Conclusion: In the anesthesia regimen for patients undergoing general anesthesia after ureteroscopic lithotripsy, the combined application of remimazolam and sufentanil has a relatively low risk of awakening agitation. At the same time, due to the influence of pharmacokinetic advantages, it can assist in improving the postoperative awakening efficiency, reduce the risk of adverse reactions and have a positive effect of stabilizing hemodynamic indicators.